Provider Demographics
NPI:1073396701
Name:CAPPELLI, AUGUSTO (RBT)
Entity Type:Individual
Prefix:
First Name:AUGUSTO
Middle Name:
Last Name:CAPPELLI
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:AUGUSTO
Other - Middle Name:
Other - Last Name:CAPPELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1790 BERKSHIRE CIR SW
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32968-6715
Mailing Address - Country:US
Mailing Address - Phone:786-586-5539
Mailing Address - Fax:
Practice Address - Street 1:1572 SE PORT ST LUCIE BLVD
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-5450
Practice Address - Country:US
Practice Address - Phone:772-212-7539
Practice Address - Fax:772-673-8392
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-23-289392106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician